Estudio de la eficacia de la buprenorfina endovenosa en pacientes pediátricos con dolor oncológico en el Hospital ION-SOLCA Dr. Juan Tanca Marengo 2008
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2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El cáncer es una enfermedad generalmente crónica y mortal. Esta cronicidad suele acompañarse de dolor por destrucción hística causada por el tumor o por el tratamiento. Este puede llegar a ser tan intenso que requerirá analgesia de alto poder considerándose a los derivados opioides los analgésicos más apropiados. Aunque existe más experiencia en adultos, su uso en niños por vía parenteral, es infrecuente haciendo poco familiar su manejo, especialmente con medicamentos nuevos como la buprenorfina, muy poco a pesar su buen desempeño analgésico. Con el objetivo de establecer la eficacia y seguridad de la buprenorfina en infusión continua frente al tramadol intravenoso en pacientes pediátricos hospitalizados en el hospital ION-SOLCA “Dr. Juan Tanca Marengo”,se realizó un estudio de tipo descriptivo correlacional, de diseño no experimental, transversal que comparó los resultados en el control del dolor dos grupos de 50 pacientes con ambos analgésicos, midiéndose el dolor con una escala visual análoga (EVA). Los resultados mostraron que buprenorfina es más eficaz en las primeras 48 horas (P< 0.05) ya que después de este periodo el resultado analgésico es muy similar (P > 0.05). La proporción de efectos colaterales no tuvo diferencias significativas entre los grupos (P > 0.05). El dolor intenso inmediato (RRA 33,3%), el dolor moderado a las 24 horas (RRA 31,67%) y el dolor moderado a las 48 horas (RRA 55%)se redujo de manera sostenida Se puede observar un menor número de pacientes con dolor intenso inmediato (OR 0,08%), el dolor moderado a las 24 horas (OR 0,064%) y el dolor moderado a las 48 horas (OR 0,013%) y puede verificarse un riesgo disminuido de dolor intenso inmediato (RR 0,65%), el dolor moderado a las 24 horas (RR 0,1%) y el dolor moderado a las 48 horas (RR 0,3%) en el grupo que empleo buprenorfina en relación con el que fue indicado con tramadol.
Cancer is a chronic and usually fatal disease. This chronic pain is often accompanied by tissue destruction caused by the tumor or treatment. This can become so intense that require high power analgesia considered to derivatives most appropriate opioid analgesics. Although more experience in adults, children use in injecting, is rare making unfamiliar handling, especially with newer drugs such as buprenorphine, which is rarely used despite its good performance analgesic. In order to establish the efficacy and safety of buprenorphine by continuous infusion compared with intravenous tramadol pediatric hospital in the ION-SOLCA, we performed a correlational descriptive study, no experimental design, cross-comparing the results in pain control two groups of 50 patients with both analgesics, pain measured with VAS. The results showed that buprenorphine is more effective in the first 48 hours (P <0.05) and after this period the analgesic result is very similar (P> 0.05). The proportion of side effects was similar in both groups (P> 0.05). The immediate pain (ARR 33.3%), moderate pain at 24 hours (RRA 31.67%) and moderate pain at 48 hours (RRA 55%) declined steadily can be observed fewer patients with immediate severe pain (OR 0.08%), moderate pain at 24 hours (OR 0.064%) and moderate pain at 48 hours (OR 0.013%) and can be verified with a decreased risk of severe pain immediately ( RR 0.65%), moderate pain at 24 hours (RR 0.1%) and moderate pain at 48 hours (RR 0.3%) in group I use buprenorphine in relation to that which was indicated by tramadol.
Cancer is a chronic and usually fatal disease. This chronic pain is often accompanied by tissue destruction caused by the tumor or treatment. This can become so intense that require high power analgesia considered to derivatives most appropriate opioid analgesics. Although more experience in adults, children use in injecting, is rare making unfamiliar handling, especially with newer drugs such as buprenorphine, which is rarely used despite its good performance analgesic. In order to establish the efficacy and safety of buprenorphine by continuous infusion compared with intravenous tramadol pediatric hospital in the ION-SOLCA, we performed a correlational descriptive study, no experimental design, cross-comparing the results in pain control two groups of 50 patients with both analgesics, pain measured with VAS. The results showed that buprenorphine is more effective in the first 48 hours (P <0.05) and after this period the analgesic result is very similar (P> 0.05). The proportion of side effects was similar in both groups (P> 0.05). The immediate pain (ARR 33.3%), moderate pain at 24 hours (RRA 31.67%) and moderate pain at 48 hours (RRA 55%) declined steadily can be observed fewer patients with immediate severe pain (OR 0.08%), moderate pain at 24 hours (OR 0.064%) and moderate pain at 48 hours (OR 0.013%) and can be verified with a decreased risk of severe pain immediately ( RR 0.65%), moderate pain at 24 hours (RR 0.1%) and moderate pain at 48 hours (RR 0.3%) in group I use buprenorphine in relation to that which was indicated by tramadol.
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Pediatría, Pacientes internos, Dolor, Anestesia intravenosa, Buprenorfina, Tramadol, Epidemiología descriptiva, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador